Healthcare Provider Details
I. General information
NPI: 1023954476
Provider Name (Legal Business Name): LUX ESTO PEDIATRIC THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
674 CHARLESINA DR
ROCHESTER MI
48306-2625
US
IV. Provider business mailing address
674 CHARLESINA DR
ROCHESTER MI
48306-2625
US
V. Phone/Fax
- Phone: 248-342-3476
- Fax:
- Phone: 248-342-3476
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVEN
ROWE
Title or Position: FOUNDER, BCBA
Credential: LLP, BCBA, LBA
Phone: 248-342-3476